Vitamin I

It’s not uncommon for trail runners to pop a little “vitamin I” to help combat the pain of a hard race. While ibuprofen can act as a powerful anti-inflammatory for post-race recovery, many runners are opting to use it before races as well—as what a recent New York Times article referred to as “a pre-emptive strike against muscle soreness.”

The article highlighted troubling findings from a small but thought-provoking study in the Netherlands on the prophylactic (pre-workout) use of ibuprofen. Existing evidence shows that strenuous exercise, in and of itself, creates small amounts of leakage from cells in the intestinal lining. While the body has a natural way of combating this damage—returning to normal within an hour of ceasing exercise, according to research—the introduction of ibuprofen may actually inhibit this natural healing process and exacerbate damage to the intestines.

Dr. Kim van Wijck, a surgical resident at Orbis Medical Center in the Netherlands, tested the effects of prophylactic ibuprofen usage in nine healthy, active men. Her research found significantly higher levels of a protein indicating intestinal leakage when the athletes used ibuprofen prior to an hour of vigorous exercise.

Though the full health implications of the study are yet to be determined, this study is not alone in shedding light on the dangers of ibuprofen usage in athletes. An oft-cited 2005 study centered on California's Western States 100 found that runners who used ibuprofen had higher plasma levels of muscle-damage markers, while delayed-onset muscle soreness, race times and even rates of perceived exertion did not differ significantly between those who used and those who didn’t.

Ibuprofen and other anti-inflammatory drugs have also been found to reduce the kidneys’ ability to flush out the byproducts of exercise, putting runners at increased risk for rhabdomyolysis. In this extreme form of muscle breakdown, myoglobin is released into the bloodstream, where it can cause severe kidney damage.

With various studies suggesting that excessive ibuprofen usage during workouts can wreak havoc on the liver, kidneys and intestines—and no evidence pointing to tangible performance benefits—it is worthwhile to stop and ask ourselves, “Is this really something my body needs?”